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Revised May 2017
INSPECTION OF BOILERS
Chapter 146: Section 6. Annual inspection; extension of time; first inspection
Section 6. All steam boilers and their appurtenances except those specified in the following section shall be thoroughly inspected externally and internally at least once a year. Upon written application made to it by the owner or user of a pressure vessel or boiler, the board may, when the public interest and convenience require, extend the time for the making of such inspection for a period not to exceed six months as the board may
determine. A district engineering inspector of the division of inspection of the Department of Fire Servicesshall perform the first inspection of steam boilers and pressure vessels required by this chapter.
Name of Facility Date Submitted
Facility Address
Contact Name Engineer in Charge
Contact Person’s Telephone Number
Contact Person’s E-mail Address License Number.
Boiler Information Manufacturer National Board Number
Year Built Mass Tag Number
MAWP Date of Last Inspection
Rated Capacity Certificate Expiration
Authorized Inspector Duration of Extension
Reason for Request :
Please attach a statement from the Authorized Inspector of record in regards to this request for an extension of the Certificate of Inspection for this Boiler or Pressure Vessel. The statement must include the Mass Tag Number of the Boiler.
COMMONWEALTH OF MASSACHUSETTS
DEPARTMENT OF FIRE SERVICESCertificate of Inspection Extension Request
Please forward this form via email to: [email protected] or mail toDepartment of Fire Services, Boiler and Pressure Vessel Program, 1 State Rd. Stow, MA 01775-1025BPV-031
